Progetto Formativo E Di Orientamento

Corso di Laurea e Laurea Magistrale in FISICA

EDUCATIONAL PROJECT 1

(rif. Convenzione n. stipulata in data )

Name and Surname: ……………..……………..……………..

born in: …………. on: …………….. resident in: ………………………………. living in: ………………………………. fiscal code: ……………………………… phone: …………….. cell.: …………….. e-mail: …………….…………….. . □ enrolled to …… year of Laurea in Fisica

- Mondo Lavoro (form 1 to 4 CFU): n. credits asked ____ - Prova finale (from 1 to 4 CFU): n. credits asked ____

□ enrolled to …… year of Laurea Magistrale in Fisica, curr. ……………..

- Attività propedeutica alla prova finale (from 1 to 3 CFU): n. credits asked ____ - Prova finale (form 1 to 30 CFU): n. credits asked ____

Hosting Company/Institute/University:

Place:

Time of access:

Period: n. months ….. from ……. To ……….

Name of Academic Tutor (university professor/researcher): Name of Tutor of Hosting Company/Institute/University:

Insurance Policies: - Accident insurance - INAIL "Gestione per Conto". - Civil liability policy n. 767407.26 issued by Fondiaria SAI – expiry date 31/10/2015

1 Data di approvazione in CCdL: ______Learning outcomes: ______

Subsidies: ______

Student’s duties: - to comply with the instructions issued by the tutors and refer to them for all organisational and other requirements; - to comply with the obligations of confidentiality over production processes, products or other company information of which they may become aware, both during and after the internship; - to comply with the company regulations and the health and safety standards.

Bologna, ……………..

1) Signature for acknowledgement and acceptance by the student

……………………………………………………….

2) Signature of the Academic Tutor

……………………………………………………….

3) Signature of the Tutor of the Hosting Company/Institute/University

……………………………………………….

4) Signature for Alma Mater Studiorum - Università di Bologna, Coordinator of Corso di Laurea e Laurea Magistrale in Fisica 2

………………………………………………..

2 The Coordinator’s signature is directly acquired by Segreteria Didattica of DIFA, where this form has to be handed in.